In the hospital setting, what is the gold standard for ETT
confirmation? – ANSWER- Chest X-Ray
What should you expect to see on a chest X-Ray if your ETT is
in the right position? – ANSWER- Distal tip of ETT should be 2-
3 cm from the carina or 1″ above the carina.
It should be at the level of the T2-T3 vertebrae.
What is the next most reliable confirmation method? –
ANSWER- Visual confirmation of the tube passing through the
vocal cords.
What is the gold standard of ETT placement in the prehospital
setting? – ANSWER- Waveform Capnograghy.
What should the pressure of the distal cuff be to prevent
damage? – ANSWER- 25-30mmHg
What can lead to a false positive of capnography? – ANSWERYou can get a false positive due to soda or beer belly for the
colorimetric device.
What is a tube check? – ANSWER- It is placing a bulb over the
ETT after intubation to confirm placement. If the ETT is in the
wrong place, the bulb with not re-inflate.
End-tidal CO2 (ETCO2) – ANSWER- The measurement of CO2
concentration at the end of expiration
Normal Range is 30-45 mmHg
What is an EMMA Emergency Capnometer – ANSWER- A
reusable ETCO2 device that gives both CO2 and RR in the
abscence of a cardiac monitor.
What is a normal expiratory plateau when measuring
capnograpghy? – ANSWER- 35-45.
List the 7 P’s of RSI. – ANSWER- 1) Preparation
2) Preoxygenation
3) Pretreatment
4) Paralysis with induction
5) Protection and positioning
6) Placement with proof
7) Post intubation management
How long should you preoxygenate your patient prior to RSI
and at what oxygen concentration? – ANSWER- 3-5 minutes,
10-15lpm if possible. `
Remember your gameplan using the A,B,C,D method. What
does this consist of? – ANSWER- A- Tube, B-Backup, C- Cric,
D- Death.
If intubation is not working, how many things should you
change? – ANSWER- 2.
What is the LOAD acronym? – ANSWER- L – Lidocaine (Head
& Lung Injury) Tight head, tight lung
O- Opiates (Blunts the pain response)
A- Atropine (Prevents reflexive bradycardia)
D- Diffisiculating Dose (small bumps of succs, roc, or vec)
____________ is a depolarizing nueromuscular
blocking agent. (NMBA) – ANSWER- Succinycholine
Succinylcholine usually causes ? – ANSWER- Muscle twitching
or fasiculations
What is the dose for Succinycholine? – ANSWER- 1-2mg / kg.
What is the onset and duration for Succinycholine? – ANSWER1-2 minute onset, 4-6 minute duration.
What are the contraindications for Succinycholine? – ANSWERCrush injuries, eye injuries, malignant hypothermia, burns.
Succinycholine can cause _________ ? –
ANSWER- hyperkalemia
What are common signs of Maligant Hyperthermia? –
ANSWER- Spasm or lock jaw (Trismus)
High fever (could be as high as 110.)
Increased ETCO2
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